What is Trichotillomania?

A great overview of trichotillomania provided by the Trichotillomania Learning Center (TLC)



What is Trichotillomania?

For an in-depth of overview of treatment guidelines and considerations for trichotillomania, download our free booklet, Experts Consensus Treatment Guidelines

Trichotillomania (trick-o-till-o-may-nee-uh) (TTM or “trich”), also known as Hair Pulling Disorder, is characterized by the repetitive pulling out of one’s hair. Trichotillomania is one of a group of behaviors known as Body-Focused Repetitive Behaviors (BFRBs), self-grooming behaviors in which individuals pull, pick, scrape, or bite their hair, skin, or nails, resulting in damage to the body.

Research indicates that about 1 or 2 in 50 people experience trichotillomania in their lifetime. It usually begins in late childhood/early puberty. In childhood, it occurs about equally in boys and girls. By adulthood, 80-90% of reported cases are women. Hair pulling varies greatly in its severity, location on the body, and response to treatment. Without treatment, trichotillomania tends to be a chronic condition; that may come and go throughout a lifetime.

Signs & Symptoms

Trichotillomania is currently classified as an “Obsessive Compulsive and Related Disorder” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

The DSM-5 diagnostic criteria include:

Recurrent hair pulling, resulting in hair loss

Repeated attempts to decrease or stop the behavior

Clinically significant distress or impairment in social, occupational, or other area of functioning

Not due to substance abuse or a medical condition (e.g., dermatological condition)

Not better accounted for by another psychiatric disorder

Hair pulling may occur across a variety of settings and both sedentary and active activities. There are times when pulling occurs in a goal-directed manner and also in an automatic manner in which the individual is less aware. Many individuals report noticeable sensations before, during, and after pulling.  A wide range of emotions, spanning from boredom to anxiety, frustration, and depression can affect hair pulling, as can thoughts, beliefs, and values.

Although the severity of hair pulling varies widely, many people with trichotillomania have noticeable hair loss, which they attempt to camouflage. Thinning or bald spots on the head may be covered with hairstyles, scarves, wigs, or makeup. Those with missing eyelashes, eyebrows, or body hair, may attempt to camouflage with makeup, clothing, or other means of concealing affected areas.

Due to shame and embarrassment, individuals not only try to cover up the effects of trichotillomania, but may avoid activities and social situations which may lead them to feel vulnerable to being “discovered” (such as windy weather, going to the beach, swimming, doctor’s visits, hair salon appointments, childhood sleepovers, readying for bed in a lighted area, and intimacy).

Impact and Effects

For some people, trichotillomania is a mild problem, merely a frustration. But for many, shame and embarrassment about hair pulling causes painful isolation and results in a great deal of emotional distress, placing them at risk for a co-occurring psychiatric disorder, such as a mood or anxiety disorder. Hair pulling can lead to great tension and strained relationships with family members and friends. Family members may need professional help in coping with this problem.

Physical effects such as pruritus, tissue damage, infection, and repetitive motion injuries to the muscles or joints are not uncommon. Those who ingest the pulled hair or parts thereof may experience gastrointestinal distress or develop a trichobezoar (hairball in the intestines or stomach), which could lead to gastrointestinal blockage and require surgical removal. Although trichobezoars are rare, they are a serious risk for those who ingest hair.

Keep reading

What causes BFRBs?

How are body-focused repetitive behaviors treated?

Read our Experts Consensus Treatment Guidelines




Have you stopped reaching?

No longer seeking greater things

Have you forgotten you have a Father listening? oh

He tells the sun when to rise

Gives the wind it’s breath

Swings a door wide open and moves in a moment you least expect

Don’t you give up on a miracle

You’ve got to speak to the impossible, oh

You’ve got to pray till you break through breaks through the ceiling keep on believing

Don’t you give up

Don’t you give up on a miracle

How many chances?

How many answers pass us by?

You know it takes faith to step on the waves when you’re terrified

So when you’re packed in a corner (corner)

And can’t wait any longer

Don’t you give up on a miracle

You’ve got to speak to the impossible, oh

You’ve got to pray till you break through breaks through the ceiling keep on believing

Don’t you give up

Don’t you give up on a miracle

Feels like the presents the words you’ve spoken

They go unnoticed like drops in the ocean

Just beyond the veil of your vision

Your mountains are moving, moving on

Remember the works his hand has done

Where you once were and how far you’ve come, oh

Don’t you give up on a miracle

You’ve got to speak to the impossible, oh

You’ve got to pray till you break through breaks through the ceiling keep on believing

Don’t you give up on a miracle (don’t you give up)

You’ve got to speak to the impossible, oh (you’ve got to speak, keep on believing)

Pray till you break through breaks through the ceiling keep on believing

Don’t you give up

Don’t you give up on a miracle

Pray till you break through breaks through the ceiling keep on believing

Songwriters: Jason Walker / Chad Mattson / Tedd Andrew Tjornhom / Jon Lowry

Miracle lyrics © Warner/Chappell Music, Inc, Capitol Christian Music Group


Living with Lukewarm Indifference

1) We’re more concerned with impressing people than living for God.

The things of this world will never fulfill us. If we try to fill the void with money, success, or some earthly dream, it will never be enough.

2) We’re obsessed with life on earth rather than eternity.

2.) Keep your eyes on things of heaven. This world is broken and is not our home. We must follow Jesus and share our faith, but not rely on this world to make us happy.

3) We rationalize sin and live without truly fearing God.

Sin separates us from God. We must repent and ask for His help to follow in His ways. Reverence of God comes from an understanding of His greatness.

4) We believe in Jesus, but we rarely share our faith.

If we really believe we are separated from God by our sin then we would be out letting our light shine all the time.

5) We only turn to God when we need Him.

Only seeking God when we need him and using him as a tool for our problems leads to an indifferent view of God. He needs to be a God we fear and worship.

6) We’re not much different from the world.

How are we different from the world? How do we spend our money, raise our kids, entertain ourselves. We need to be transformed by Jesus and be different because we are not from this world, we are called to more. Are you a full time mom or student or teacher and a part time follower of Christ or a full time follower of Christ who uses His teachings and guidance to for fill other roles in our life?

How do we reignite the fire to pursue Jesus daily? 🔥

Most importantly: every day do something that requires faith daily habits to keep your relationship strong

1. Spend time in the word daily
2.Pray continually 🙏🏻
3.Worship daily
4.Share faith
5.Confess sin

It’s better to hurt with a purpose than to exist without one.

Be diligent, turn from your indifference and turn to Jesus. By doing something that requires faith you become more concerned with what God thinks of you than what people think of you. It will make you bold in spirit. You need him minute by minute and will be transformers because Jesus lives in you.



Hope for Bipolar Depression

Even in our darkest places, we will eventually realize that there is hope to get through our tragedies and hardships. What may seem hopeless one day, will lead into another, that will assure us that depression does not last forever. When we are in the middle of it, we cannot see the light, but upon reflection, many realize that there is room to grow and learn from our experiences, no matter how bleak and dark. I know this to be true when attempting to fight off the darkness that never seems to end.

Depression is an element of bipolar disorder that we can never escape, but it is truly in reaching out for help that will bring us on a journey of recovery and acceptance that makes it okay to not be okay. It is imperative to know that clinical depression is not always triggered by something in particular, and there is often not a ‘reason’ for the experience. We are plainly dealing with a mental illness that often has no specific logical circumstantial indicator. As we travel through the valleys, we just have to remember than one day, we will once again soar into a place of stability and balance. Taking the first step by reaching out may be the most difficult, but it is also one of the most vital decisions that you will ever have to make.

Keep your heads up guys and know that you too are worthy of understanding, acceptance, and empathy. Never be afraid to ask for the help that you so rightfully deserve.